| MRI of the perihemorrhagic zone in a rat ICH model: effect of hematoma evacuation. | |
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MedLine Citation:
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PMID: 18188706 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Perihemorrhagic pathophysiology of spontaneous intracerebral hemorrhages (ICH) remains unclear. Recently, ischemic changes in the perihemorrhagic zone (PHZ) have been discussed as a potential source of secondary damage. In this study, we focussed on diffusion and perfusion characteristics of experimental ICH. METHODS: Experimental ICH was induced with a double injection model in rats. In total, 49 animals were examined at three timepoints within 3.5 h after ICH with a 2.35T animal scanner. We investigated perihemorrhagic relative apparent diffusion coefficients (rADC) and relative mean transit time (rMTT). Animals were divided into 2 groups; controls (gr1, n = 27) and facilitated hematoma evacuation with recombinant tissue plasminogen activator (rt-PA) after the first of 3 imaging time points (gr2, n = 22). Diffusion (rADC) and perfusion (rMTT) characteristics were analyzed in 3 regions of interest surrounding the hematoma (ROI1-3). RESULTS: Overall rADC and rMTT values in ROI3 (normal tissue) did not show any changes. There was mild edema--not ischemia--in ROIs1 and 2 at TP1 with rADC of 1.05-1.18 in both groups indicating vasogenic edema (not ischemia). This did not change with hematoma evacuation. There was mild (non-critical) perfusion reduction in ROIs1 and 2 at TP1, which disappeared after clot evacuation in group 2 (P < 0.05 for TP3). Multifactorial ANOVA showed a solid trend (0.06 < P < 0.1) for clot evacuation associated normalization of perfusion in ROIs 1 and 2 within and in between groups 1 and 2. CONCLUSIONS: We demonstrated vasogenic edema and mild perfusion reduction in the PHZ above the ischemic threshold. The existence of a perihemorrhagic "penumbra" indicating critically ischemic tissue analogous to ischemic stroke is unlikely. |
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Authors:
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Berk Orakcioglu; Kristina Becker; Oliver W Sakowitz; Christian Herweh; Martin Köhrmann; Hagen B Huttner; Thorsten Steiner; Andreas Unterberg; Peter D Schellinger |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Neurocritical care Volume: 8 ISSN: 1541-6933 ISO Abbreviation: Neurocrit Care Publication Date: 2008 |
Date Detail:
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Created Date: 2008-05-15 Completed Date: 2008-09-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101156086 Medline TA: Neurocrit Care Country: United States |
Other Details:
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Languages: eng Pagination: 448-55 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, University Hospital Heidelberg, Im Neuenheimer Feld 400, Heidelberg, Germany. berk.orakcioglu@med.uni-heidelberg.de |
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Brain / pathology Brain Edema / pathology Brain Ischemia / pathology* Cerebral Hemorrhage / pathology*, surgery* Cerebrovascular Circulation Disease Models, Animal Hematoma / pathology*, surgery* Magnetic Resonance Imaging* Male Rats Rats, Wistar |
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